What does Semen Analysis Say about your Fertility

Ali, 32, and his wife, married for five years, had been trying for a child from the beginning of their marriage. Though sexually active, they were yet to hear the patter of tiny feet in their household.

Ali, though frustrated, was confident that there was nothing wrong with him because he did not smoke and had been living an active healthy lifestyle since young. So his wife made the first move to consult a doctor but the gynaecologist found there was nothing wrong with her. Ali, however, faced a different outcome when he sought medical advice.

He had bilateral varicoceles and from a seminal analysis, it was discovered that he had OAT syndrome or oligoasthenoteratozoospermia (low number of sperm, poor sperm movement, and abnormal sperm shape). Due to these issues, his sperm count was only five million at the time of diagnosis. 

Above is an excerpt from New Straits Times (2017), depicting the current issue on male infertility.

Semen analysis is a scientific examination of semen fluid to investigate male infertility or effectiveness of vasectomy procedure. The accuracy of the semen analysis might be affected by individual variables, environmental and physiological factors.

Two or more separate sperm analysis are to be done within 2-3 weeks interval. If the first test result is found to be abnormal, patients are to take another test. A man could not be diagnosed as infertile as long there are live sperm in the semen.


What you should know about providing a Proper Semen Sample

  • 2-3 days before collection of the sperm, abstain from sexual intercourse or masturbation.
  • Avoid caffeine, alcohol and marijuana for at least 3 months before the sperm analysis.
  • Inform the doctor if you are taking any medications or any herbal remedies.
  • Collection of sperm through masturbation is preferred.
  • If it is against the practice of your religion, you may collect the sperm using a special type condom during sexual intercourse.
  • Do not use lubricant, soap or perfume during sample collection.
  • Most preferably, collect the specimen in a private room in the healthcare office.
  • The sample must be delivered to the lab within one hour after ejaculation.
  • If the patient collects the sample at home, remember to keep it in room temperature and bring it to the lab as soon as possible.
  • Avoid providing sample when you are unwell or stressed.

What do the semen analysis results mean?

Semen Characteristic Reference Value
Volume (ml) 1.5
Vitality (% live) 58
Concentration (106/ml) 15
Total Sperm Count (106) 15
Motility (Progressive) %
 32
Total Motile % 40
Normal Morphology (%) 4

Nice.Org.UK World Health Organisation 2010


Semen Analysis Characteristics Explained:

  • Volume – measures the volume of submitted semen sample.

    The minimum volume should be greater than 1.5 ml or at least half a teaspoon. For volume less than this, it might be indicative of a block in the sperm duct or a semen collection problem. On the other hand, excess fluid indicates the amount of sperm is diluted or an inflammation in the reproductive system.

  • Sperm count- number of sperm per millilitre.

    Sperm count should be at least 15 million/ml. Anything less than this indicates a low sperm count.

  • Sperm movement- also known as the sperm motility, measures the % of active sperm showing efficient movement. A low motility measure equates a reduced sperm capacity to move through the female reproductive system to fertilize the egg.

    At least 40% of the sperm should be demonstrating motility.

    Progressive motility specifies motile sperm that moves forwards in a straight line or large circles, whereas non-progressive motile sperm are more likely to move in tight circles. At least 32% of the sperm should be demonstrating progressive motility.

  • Sperm shape- also known as the morphology, measures % of normal sized and shaped sperm. Normal sperm have long tail and oval shaped head. Abnormal sized or shaped sperm can have difficulty reaching, penetrating and fertilizing the egg.

    Usual range is 4-14% sperm with standard form. You want at least 4% of sperm to be of normal shape, otherwise you could have fertility issues because of sperm morphology.

  • White blood cells – presence of white blood cells in semen specimen indicates signs of infection.

    White blood cells - presence of white blood cells in semen specimen indicates signs of infection.

To learn more details about the entire process, please check out KLF website Male Infertility Investigation on normal sperm count and other parameters involved in a semen analysis.


Why is sperm analysis done?

  • To assess the fertility status based on sperm characteristics
  • Post vasectomy check for the success of the vasectomy procedure. (Procedure is successful only if no sperm is found)

How can you improve your sperm quality?

  • Avoid alcohol intake
  • Stop smoking
  • Stay away from high temperature places such as spa, thermal bath and sauna.
  • Avoid tight underwear or jeans
  • Complete antibiotic course prescribed by the doctor if you have white blood cell in semen.
  • Take supplements such as vitamin E or zinc.

If your sperm analysis results appear abnormal, the doctor will recommend further investigations into the underlying cause in order to formulate a treatment plan. For instance, KL Fertility Centre, a fertility specialist centre does provide other investigations which include hormone tests, imaging test and diagnostic surgical procedures such as sperm mapping. Many cases of male infertility are treatable with lifestyle changes, medications, surgery and other interventions.

*Article contributed by Leelah from GetDoc

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